Name of Business / Taxpayer
Identification Number
Nature of Business
For Financial Year

2**-Line Statement (Revenue < $200,000)**

<delete this section if not applicable>

First line Revenue $ Section A
Second line Adjusted Profit/Loss $ Section H

4-Line Statement (Revenue > $200,000)

<delete this section if not applicable>

First line Revenue $ Section A
Second line Gross Profit/Loss $ Section C
Third line Allowable Business Expenses $ Section G
Fourth line Adjusted Profit/Loss $ Section H

Section A

Revenue (Total Sales or Income) <INPUT>
(Refer to Appendix 2)

Section B

Cost Of Goods Sold <INPUT>
Opening Trading Stock -
Closing Trading Stock +
Trading Stock Purchased (Refer to Appendix 3)

Section C = A - B

Gross Profit / Loss <CALCULATE>
Revenue less Cost of Goods Sold

Section D

Business Expenses <INPUT>
(Refer to Appendix 4)
Telephone
Utility
Rental
Etc

Section E

Transport Expenses <INPUT>
(Refer to Appendix 5)

Section F

Staff Enumeration Expenses <INPUT>
(Refer to Appendix 6)